Age and health factors in breakthrough deaths

New findings have identified the characteristics most associated with people who have died from Covid-19 despite being double vaccinated.

Photograph of the hands of a healthcare worker in rubber gloves preparing a covid vaccne

The main predictors of post-vaccination Covid-19 deaths were being aged 80 or older, having multiple underlying health conditions and being male.

The results come from the Scotland-wide EAVE II Covid-19 surveillance platform.

Cause of death

Of the 3.2 million people who had received two vaccine doses in Scotland by 18 August 2021, 236 had died with Covid-19. Of these, the majority were around 80 years of age and 62 per cent were male.

As well as Covid-19, 97 per cent of the group had at least one other cause listed on their death certificate.

The most common causes were chronic heart or kidney disease, diabetes, chronic obstructive pulmonary disease, and/or a fast or irregular heartbeat.

Data analysis

The study analysed those fully vaccinated with the Pfizer or AstraZeneca vaccines. There were no deaths registered during the study period in the smaller group of people vaccinated with the Moderna vaccine.

The EAVE II project tracks the Covid-19 pandemic in Scotland in near real-time using a dataset of all 5.4 million people registered with a GP in Scotland, which is around 98 per cent of the Scottish population.

The project is led by researchers at the University of Edinburgh, working in collaboration with the Universities of St. Andrews, Strathclyde and Aberdeen; Public Health Scotland; and the West of Scotland Specialist Virology Centre.

The results are published as a research letter in The Lancet. Research letters are externally peer-reviewed, and their findings are usually preliminary or exploratory.

Our findings suggest that adults aged 18 to 64 years old who are double vaccinated have almost four times increased protection against dying from Covid-19 compared to those who are unvaccinated. The figures are even more stark for those who are older, with double vaccinated adults aged 65 to 79 years old experiencing 15.5 times greater protection against death than their unvaccinated peers, and for adults over 80, this increased to 30 times higher.

Dr Josie MurrayConsultant at Public Health Scotland

Dr Murray went on to say it is hugely important that when invited for a Covid-19 vaccine, whether it be a first, second or booster dose, people take the opportunity to bolster your protection.

Our work has consistently found that vaccines overall are very effective at preventing hospital admissions and deaths from Covid-19. This whole country analysis – one of the first of its kind in the world – does however show that unfortunately some people do die from the virus despite being vaccinated with two doses.

Professor Aziz SheikhDirector of University of Edinburgh's Usher Institute 

The study was funded by the Medical Research Council, UK Research and Innovation Industrial Strategy Challenge Fund, the National Institute for Health Research and Health Data Research UK (HDR UK), and was supported by the Scottish Government.

Additional support was provided through the Scottish Government Director-General Health and Social Care, and the UKRI COVID-19 National Core Studies Data and Connectivity programme led by HDR UK.

Related links

Article published in The Lancet

Find out more about the EAVE II study

Data Driven Innovation at Edinburgh

[Image credit: Morsa Images via Getty Images]